The Skin Picking Impact Project: Phenomenology, interference, and treatment utilization of pathological skin picking in a population-based sample
Research highlights
▶ Adults with self-reported problematic skin picking (PSP) showed considerable heterogeneity in picking methods, body sites, and function (e.g., regulation of emotional, sensory, and cognitive states). ▶ Adults with self-reported PSP generally reported moderate psychosocial and physical impact from picking, and tended to perceive available treatment as poor in quality. ▶ In adults with PSP, the severity of associated symptoms of psychopathology (depression, anxiety, and stress) were comparable to severity levels found in previous samples of persons with trichotillomania and obsessive–compulsive disorder. ▶ PSP severity was a statistically significant predictor of overall impairment after controlling for depression and anxiety symptoms.
Section snippets
Participants
This study was approved by the University of Wisconsin–Milwaukee's Institutional Review Board. Researchers recruited participants from seven separate online resources for persons with PSP and related conditions. Each of the sites was chosen because they provided some combination of peer support, treatment/referral resources, and education for persons with PSP or similar problems. The recruitment sources were as follows: (1) StopPicking.com (www.stoppicking.com), (2) Pickaderms (//www.health.groups.yahoo.com/group/pickaderms/
Materials
Several of the authors (BTPT, DWW, MEF, CAF) created the Skin Picking Impact Survey (SKIS; available from the corresponding author), which contained individual items and standardized measures assessing demographics, PSP phenomenology and severity, associated symptoms of psychopathology, physical and psychosocial impact of PSP, and treatment-seeking practices. Portions of the survey used in the current investigation are described below.
Demographics
Demographic characteristics are reported in Table 1. Most participants were females and of White/Caucasian ethnicity, with a mean age of 34.0 (SD = 11.9).
Current picking
Most participants reported that they currently picked from their face, but numerous other sites were endorsed (see Table 2). The average number of picking sites endorsed was 4.73 (SD = 2.94).
As seen in Table 3, Table 4, the majority of participants reported awareness of their picking and that the behavior was preceded by an urge. Though not as
Discussion
The purpose of this study was to provide population-based data on PSP that can be used to help generate hypotheses for further study of PSP. Results suggest that PSP is: (1) heterogeneous in its topography, function, and severity; (2) associated with levels of depression, anxiety, and stress symptoms that are comparable to those found in other psychiatric disorders (i.e., TTM, OCD); (3) related to overall functional impairment, possibly independent of co-occurring symptoms of psychopathology;
Acknowledgements
The authors would like to thank Christopher Bauer, Kathryn Kalvoda, and Claire Stark for survey piloting and surveymonkey entry; the owners and moderators of the online recruitment resources; and all the individuals who took the time to participate in this study.
References (32)
- et al.
Fluoxetine in pathologic skin-picking: open-label and double-blind results
Psychosomatics
(2001) - et al.
Trichotillomania: impact on psychosocial functioning and quality of life
Behaviour Research and Therapy
(2005) - et al.
Pathological skin picking in individuals with body dysmorphic disorder
General Hospital Psychiatry
(2006) - et al.
Skin picking behaviors: an examination of the prevalence and severity in a community sample
Journal of Anxiety Disorders
(2009) - et al.
The Skin Picking Impact Scale (SPIS): scale development and psychometric analyses
Psychosomatics
(2001) - et al.
Repetitive skin-picking in a student population and comparison with a sample of self-injurious skin-pickers
Psychosomatics
(2000) - et al.
The prevalence of pathological skin picking in US adults
Comprehensive Psychiatry
(2010) - et al.
The skin picking scale: scale construction and psychometric analyses
Journal of Psychosomatic Research
(2001) - et al.
Clinical characteristics and medical complications of pathological skin picking
General Hospital Psychiatry
(2008) Diagnostic and statistical manual of mental disorders
(2000)
Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample
Psychological Assessment
Characteristics of 34 adults with psychogenic excoriation
Journal of Clinical Psychiatry
Skin picking in German students: prevalence, phenomenology, and associated characteristics
Behavior Modification
Phenomenological characteristics, social problems, and the economic impact associated with chronic skin picking
Behavior Modification
Should we trust web-based studies? A comparative analysis of six perceptions about internet questionnaires
American Psychologist
ECDEU assessment manual for psychopharmacology
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